The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children

Western Michigan University ScholarWorks at WMU Dissertations Graduate College 8-1985 The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children George Kahle Henry Western Michigan University Follow this and additional works at: http://scholarworks.wmich.edu/dissertations Part of the Psychoanalysis and Psychotherapy Commons Recommended Citation Henry, George Kahle, "The Effects of Symbolic Modeling and Parent Training on Noncompliance in Hyperactive Children" (1985). Dissertations. 2320. http://scholarworks.wmich.edu/dissertations/2320 This Dissertation-Open Access is brought to you for free and open access by the Graduate College at ScholarWorks at WMU. It has been accepted for inclusion in Dissertations by an authorized administrator of ScholarWorks at WMU. For more information, please contact maira.bundza@wmich.edu.

THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONC OMPLIANCE IN HYPERACTIVE CHILDREN by George Kahle Henry A Dissertation Submitted to the Faculty of The Graduate College in partial fulfillment of the requirements for the Degree of Doctor of Philosophy Department of Psychology Western Michigan University Kalamazoo, Michigan August 1985

THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONCOMPLIANCE IN HYPERACTIVE CHILDREN George K ahle H enry, Ph.D. W e stern M ichigan U n iv e r s ity, 1985 T h is s tu d y exam ined th e i n t e r a c t i o n s o f m o th ers w ith t h e i r h y p e r a c tiv e c h i ld r e n d u rin g a s t r u c t u r e d - t a s k p e r io d to d e te rm in e th e e f f e c t s o f a sy m b o lic m odeling and p a r e n t t r a i n i n g in t e r v e n t i o n on c h i ld n o n co m p lia n ce. A n a ly s is o f v id e o ta p e d s e q u e n c e s a c ro s s a l l p h a s e s o f th e s tu d y in d i c a t e d t h a t sy m b o lic m o d elin g v/as n o t a v e ry e f f e c t i v e te c h n iq u e f o r im p ro v in g c o m p lia n ce in h y p e r a c tiv e c h i l d r e n. P h ase one o f p a r e n t t r a i n i n g, w hich ta u g h t m o th ers a p p r o p r i a te a t te n d i n g, ig n o r in g, and re w a rd in g b e h a v io r s, was more e f f e c t i v e th a n sy m b o lic m o d e lin g. P h ase two o f p a r e n t t r a i n i n g, w hich in tr o d u c e d a tim e - o u t c o n tin g e n c y f o r n o n c o m p lia n c e, was th e m ost e f f e c t i v e i n t e r v e n t i o n a s i t r e s u l t e d in s i g n i f i c a n t r e d u c t io n s in c h i l d n o n c o m p lia n c e. D u rin g p h ase two a l l s i x c h i ld r e n r e v e a le d im provem ents i n t h e i r r a t e s o f c o m p lia n c e w ith fo u r re a c h in g s i g n i f i c a n t l e v e l s. S i g n i f i c a n t r e d u c t io n s in la te n c y to com ply w ere e x h ib ite d by fo u r o f th e s i x s u b j e c t s, and a l l s u b je c ts in c r e a s e d t h e i r r a t e s o f t a s k c o m p le tio n w ith two r e a c h in g s t a t i s t i c a l s i g n i f i c a n c e. P a r e n t t r a i n i n g v/hich in c o r p o r a te s a tim e - o u t p ro c e d u re a p p e a rs to o f f e r a p ro m isin g tr e a tm e n t s t r a t e g y f o r n o n co m p lia n ce i n h y p e r a c tiv e c h i ld r e n.

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8524458 Henry, George Kahle THE EFFECTS OF SYMBOLIC MODELING AND PARENT TRAINING ON NONCOMPLIANCE IN HYPERACTIVE CHILDREN W estern M ichigan University Ph.D. 1985 University Microfilms International 300 N. Zeeb Road, Ann Arbor, Ml 48106 Copyright 1985 by Henry, George Kahle All Rights Reserved

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Copyright by George K. Henry 1985

ACKNOWLEDGEMENTS I w ish to e x p r e s s my a p p r e c i a t i o n and g r a t i t u d e to D r. R o d e n h iz e r, D r. C re a g e r, D r. B e c k e r, and s t a f f o f th e K alam azoo C h ild G uidance C lin ic f o r t h e i r s u p p o rt and a s s i s t a n c e th ro u g h o u t t h i s p r o j e c t. I w ould l i k e to th a n k Jim K i r k l i n, c h i e f e n g in e e r o f I n s t r u c t i o n a l C om m u n icatio n s, f o r h i s t r u s t and p a t ie n c e i n le n d in g me v id e o ta p e equip m en t and s u p p lie s f o r th e academ ic y e a r so t h a t t h i s s tu d y c o u ld be c o m p le te d. I w ould a l s o l i k e to th a n k D r. P a u l T. M o u n tjo y, my a d v i s o r, who h as p ro v id e d much encouragem ent and s u p p o rt th ro u g h o u t my y e a rs h e re a t W estern M ich ig an U n iv e r s it y. F i n a l l y, I owe many th a n k s to my w if e, K a th le e n, who s tr o n g l y s u g g e s te d t h a t I ta k e tim e o u t f o r s o c i a l a c t i v i t i e s, e s p e c i a l l y d u rin g t h i s l a s t y e a r, as sh e a p p e a rs to h ave a knack f o r k e e p in g my f e e t on th e g ro u n d, w hich i s w here th e y s h o u ld be I G eorge K ahle Henry

TABLE OF CONTENTS ACKNOWLEDGEMENTS... i i LIST OF TA BLES... iv LIST OF F IG U R E S... V C h a p te r I. INTRODUCTION... 1 I I. M ETH O D... 7 S u b je c ts....... 7 P r o c e d u r e...10 B a s e l i n e...10 Sym bolic M odeling....... 12 P a r e n t T r a i n i n g... 15 D ependent V a r i a b l e s... 20 R e l i a b i l i t y...22 I I I. RESU LTS... 23 S u b je c ts... 23 Rmaov... 53 R e l i a b i l i t y......... 53 IV. D IS C U S S IO N...55 APPENDICES......... 67 BIBLIOGRAPHY... «... 78 i i i

LIST.OF TABLES T a b le 1. 2. 3. k. 5. 6. 7. Page S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t... 27 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t...3 2 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t- C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r im e n t...37 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r i m e n t....1 S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e r i m e n t... S ig n if ic a n t Changes in Mean V alues fo r P a r e n t - C h ild B e h a v io r A cro ss A ll F our P h a s e s o f th e E x p e rim e n t...50 I n te r o b s e r v e r R e l i a b i l i t y f o r D ependent V a r ia b le s... 5^ LG iv

LIST OF FIGURES F ig u re P age 1. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r Tommy... 25 2. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r P h i l i p... 30 3. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r M aggie... 35 L a te n c y t o I n i t i a t e C om pliance to M a te rn a l Commands f o r J a c o b....... 38 5. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r S h a v m...ll 6. L a te n c y to I n i t i a t e C om pliance to M a te rn a l Commands f o r S r i c...i+8 7. Mean P e rc e n ta g e f o r P a te o f C om pliance V /ith in F iv e S econds o f Command...51 8. Mean P e rc e n ta g e f o r P a te o f T ask C o m p l e t i o n...3 2 v

CHAPTER I INTRODUCTION H y p e r a c t iv ity i s p r e s e n t l y b e lie v e d to be th e le a d in g r e f e r r a l p ro b le m to c h i l d g u id a n c e c l i n i c s i n t h i s c o u n try. E s tim a te s o f i t s o c c u rre n c e i n th e s c h o o l-a g e p o p u la tio n r a n g e s from 2-2 0 ^ (B a r k le y, 1 9 81). The h y p e r a c tiv e syndrom e i s t y p i c a l l y c h a r a c t e r i z e d by th e p re s e n c e o f s e v e r a l b e h a v io rs in c lu d in g : im p u l s i v i t y, i n a t t e n t i o n, and o v e r a c t i v i t y. In a d d i t i o n, h y p e r a c tiv e c h i ld r e n a r e o f te n d e s c r ib e d by t h e i r p a r e n t s as b e in g n o n c o ra p lia n t, r e q u i r i n g r e p e a te d commands b e f o r e even p a r t i a l, though te m p o ra ry c o m p lia n ce o c c u rs. N oncom pliance i s one o f th e b e h a v io r p ro b le m s t h a t p a r e n t s r e p o r t m ost f r e q u e n t ly (K a ro ly & R o s e n th a l, 1977; F o re h a n d, 1977; F o re h a n d, 1981; P a tt e r s o n & R e id, 1973). B e h a v io rs w hich may be subsum ed u n d er th e c a te g o r y o f n o n co m p lia n ce in c lu d e : n o t d o in g th e re q u e s te d b e h a v io r, p e rfo rm in g i t to o s lo w ly, e x h i b i t i n g lo n g l a t e n c i e s betw een th e r e q u e s t and i n i t i a t i o n o f c o m p lia n c e, s h o r t d u r a tio n o f c o m p lia n c e, p ro m is in g to do i t l a t e r, s t a t i n g a r e f u s a l to com ply, and e n g a g in g i n a co m p etin g re s p o n s e in c o m p a tib le w ith c o m p lia n c e. I n some c a s e s, low co m p lia n c e r a t e s a r e a f u n c tio n o f p a r t i c u l a r a n te c e d e n t c o n d i tio n s su ch a s th e to p o g ra p h y o f

th e r e q u e s t d e l iv e r e d. F o r i n s t a n c e, a r e q u e s t p o sed i n a t e n t a t i v e to n e o r one v/hich r e q u i r e s th e p e rfo rm a n c e o f a b e h a v io r c u r r e n t l y n o t i n th e c h i l d 's r e p e r t o i r e o f r e s p o n s e s may o c c a s io n q u ite a d i f f e r e n t r e s p o n s e th a n one s t a t e d f ir m ly, d e c i s i v e l y, and w ith in th e b e h a v io r a l c a p a b i l i t i e s o f th e c h i l d. F u rth e rm o re, s t u d i e s i n th e la b o r a t o r y h av e r e v e a le d t h a t th e co n se q u e n c e s o f r e s p o n d in g, su ch as re w a rd s f o r co m p lia n ce o r p u n ish m e n t f o r n o n c o m p lia n c e, a r e a l s o im p o rta n t v a r i a b l e s t h a t c o n t r o l n o n co m p lia n ce (F o reh an d & K in g, 197K). T h u s, i t l o g i c a l l y f o llo w s t h a t n o n co m p lia n ce may be sh a p e d up and m a in ta in e d as a r e s u l t o f th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s w ith in th e fa m ily sy ste m. Some o f th e f i r s t s t u d i e s o f p a r e n t - c h i l d i n t e r a c t i o n s o f h y p e r a c tiv e c h i ld r e n (C am p b e ll, 1973; C am p b ell, 1973; B a r k le y & Cunningham, 1979; Cunningham & B a r k le y, 1979) hav e r e v e a le d a d i f f e r e n t p a t t e r n o f i n t e r a c t i o n e x h i b ite d by m o th ers o f h y p e r a c tiv e c h i ld r e n com pared to th e m o th ers o f n o rm a l o r le a r n in g d is a b le d c h i l d r e n. M others o f h y p e r a c tiv e c h i ld r e n t y p i c a l l y e x h i b it s i g n i f i c a n t l y more a t te m p ts a t c o n t r o l, d i r e c t i o n, and i n g e n e r a l, s t r u c t u r i n g o f t h e i r c h i l d r e n 's b e h a v io r. The m o th ers o f h y p e r a c tiv e c h i l d r e n te n d to g iv e more commands and n e g a tiv e s ta t e m e n ts, and a r e l e s s r e s p o n s iv e to t h e i r c h i l d 's i n t e r a c t i o n s. T hese s t u d i e s s u g g e s t t h a t p a r e n t - c h i l d i n t e r a c t i o n s m ight b e s t be c o n c e p tu a liz e d as a r e c i p r o c a l fe e d b a c k sy ste m in

v/hich th e b e h a v io r o f one p e r s o n s e r v e s a s b o th a d i s c r i m i n a t i v e s tim u lu s and a c o n s e q u a tin g e v e n t f o r th e re s p o n s e o f th e o t h e r. T h u s, th e s e q u a l i t a t i v e d if f e r e n c e s i n p a r e n t - c h i l d i n t e r a c t i o n s betv /een h y p e r a c tiv e c h i ld r e n and t h e i r m o th ers may r e i n f o r c e and m a in ta in a h o s t o f n o n c o m p lia n t b e h a v io r s. T h u s, s u c c e s s f u l tr e a tm e n t m ight r e l y upon an i n t e r v e n t i o n s t r a t e g y v/hich im p a c ts on b o th th e c h i l d and th e p a r e n t a s o p posed to tr e a tm e n t f o c u s in g on on ly one member of th e dyad. V /hile m e th y lp h e n id a te ( R i t a l i n ) p r e s e n t l y re m a in s th e tr e a tm e n t o f c h o ic e f o r h y p e r a c t i v i t y, v a r io u s i s s u e s need to be c o n s id e r e d v/hen e v a lu a tin g th e u s e f u ln e s s o f t h i s form o f th e r a p y. T hese i s s u e s in c lu d e th e n e g a tiv e s id e e f f e c t s o f s t i m u l a n t s, i n e f f e c t i v e n e s s, and th e lo n g -te rm c o n se q u e n c e s o f p s y c h o s tim u la n t m e d ic a tio n. A number o f n e g a tiv e s i d e e f f e c t s h ave b ee n found i n 10-20# o f a l l c h i ld r e n g iv e n m e d ic a tio n. The m ost common s id e e f f e c t s a r e in s o m n ia, c o n v u ls io n s, stom ach p a i n s, i r r i t a b i l i t y, lo s s o f a p p e t i t e, in c r e a s e d h e a r t r a t e, p h o t o s e n s i t i v i t y o f th e s k i n, and p s y c h o tic e p is o d e s (C ohen, D ouglas & M organs t e r n, 1971; K a tz, S a r a f, G ittle m a n - K le in A- K le in, 1 9 75). C o n cern in g th e i s s u e o f i n e f f e c t i v e n e s s, n e a r l y 23% o f a l l h y p e r k i n e tic c h i l d r e n r e c e i v i n g s tim u la n t d ru g s rem ain u n changed o r d e t e r i o r a t e b e h a v io r a ll y ( B a r k le y, 1977; R a p o p o rt, Q uinn, B ra d b a rd, R id d le & B ro o k s, 1 9 7 4 ). A lth o u g h in c o n c lu s iv e, r e c e n t r e s e a r c h i n t o th e lo n g - te rm s id e e f f e c t s

o f m e th y lp h e n id a te and d ex tro am p h etam in e tr e a tm e n t h as r e v e a le d a 75-83/4 s u p p r e s s io n o f e x p e c te d y e a r l y grow th ( S a f e r & A lle n, 1975; S a f e r, A lle n & B a r r, 1972). H ow ever, g row th s u p p r e s s io n h a s b een r e p o r t e d to reb o u n d fo llo w in g w ith d ra w a l o f d ru g s ( S a f e r e t a l., 1 9 7 2 ). T hese s e r io u s c o n c e rn s a s s o c ia te d w ith th e u s e o f p s y c h o s tim u la n t m e d ic a tio n s e t s i n m o tio n a p l e t h o r a o f e t h i c a l c o n s id e r a tio n s w hich e x e r t i n c r e a s i n g p r e s s u r e on h e a lth c a re p r a c t i t i o n e r s to i n v e s t i g a t e and d is c o v e r more e f f i c a c i o u s and s o c i a l l y a p p r o p r i a te m ethods o f m anaging b e h a v io r p ro b le m s a s s o c ia te d v /ith h y p e r a c tiv e c h i l d r e n, r'o n m e d ic a l a p p ro a c h e s, su ch as b e h a v io r th e r a p y and b e h a v io r m o d if ic a tio n may o f f e r a p ro m is in g a l t e r n a t i v e. T h e ra p e u tic te c h n iq u e s f o r h y p e r a c t i v i t y may be d iv id e d i n t o two m ajor c a t e g o r i e s : m e d ic a l and n o n m e d ical m anagem ent. B e h a v io r a l management o f h y p e r a c t i v i t y i s p r e s e n t l y th e m ost f r e q u e n t ly u s e d n o n m e d ical ap p ro ach (B ru n a a g e -A g u a r, F o reh an d & C im in e ro, 1976). B e h a v io r a l tr e a tm e n t a p p ro a c h e s h av e em ployed su ch te c h n iq u e s as d i f f e r e n t i a l re in f o r c e m e n t o f o th e r b e h a v io r (T w ardosz & S a jw a j, 1 9 7 2 ), w ith d ra w a l o f p o s i t i v e r e in fo rc e m e n t (S a c h s, 1973)» and punishm ent (G ilan d as 8t B a ll, 1975)* W hile sy m b o lic m o d e lin g i n th e form o f v id e o ta p e h as b e e n u sed s u c c e s s f u l l y in th e tr e a tm e n t o f a w ide ra n g e o f c h i l d r e n s ' p ro b le m s in c lu d in g p h o b ia s (L e w is, 197^5 K o rn h ab er & S c h ro e d e r, 1 9 7 5 )j s o c i a l i s o l a t i o n (E v e rs -P a s q u a le &

S herm an, 1 9 7 5 )5 a t t e n t i v e n e s s ( K e lle r & C a r ls o n, 1 9 7 k ), and im p ro v in g o r a l h y g ie n e (M urray & S p s t e in, 1 9 8 1 ), o n ly one s tu d y (C o p e la n d, 1977) u t i l i z e d v id e o ta p e fe e d b a c k a s an i n t e r v e n t i o n s t r a t e g y w ith h y p e r a c tiv e c h i l d r e n. A m ajor s o u rc e o f s o c i a l l e a r n i n g i s th e ab u n d a n t and v a r i e d s y m b o lic m o d e lin g p ro v id e d by t e l e v i s i o n, f i l m s, and o th e r v i s u a l m e d ia. I t h a s b ee n d e m o n stra te d t h a t b o th c h i ld r e n and a d u l ts a c q u ir e a t t i t u d e s, e m o tio n a l r e s p o n s e s, and new ways o f b e h a v in g th ro u g h film e d and t e l e v i s e d m o d e lin g (B a n d u ra, 1973; L i e b e r t, H eale & D av id so n, 1973). No s t u d i e s to d a te hav e i n v e s t i g a t e d th e e f f e c t s o f sy m b o lic m o d e lin g, i. e., v id e o ta p e, on n o n com p lia n ce i n h y p e r a c tiv e c h i l d r e n. T h e r e f o r e, one o b je c tiv e o f th e p r e s e n t s tu d y was to i n v e s t i g a t e th e e f f e c t s o f sy m b o lic m o d e lin g on n o n co m p lia n ce i n h y p e r a c tiv e c h i ld r e n. Some a t t e n t i o n h a s b ee n d e v o te d to i d e n t i f y i n g th e ty p e s o f p e o p le who a r e m ost re s p o n s iv e to m o d e lin g i n f l u e n c e s. T hose who la c k c o n fid e n c e and s e l f - e s t e e m, who a r e d e p e n d e n t, and who have b ee n f r e q u e n t ly re w a rd e d f o r i m i t a t i v e b e h a v io r a r e e s p e c i a l l y p ro n e to a d o p t th e b e h a v io r o f s u c c e s s f u l m odels (B an d u ra, 1 9 77). A cco rd in g t o B a rk le y (1981) low s e lf - e s t e e m i s a f r e q u e n t, th o u g h l i t t l e s t u d i e d, e m o tio n a l pro b lem o f te n c h a r a c t e r i z i n g h y p e r a c tiv e c h i l d r e n. T h u s, th e y may p ro v e to be q u ite s u s c e p t i b l e to m o d e lin g i n f l u e n c e s. I t was e x p e c te d t h a t s y m b o lic m o d e lin g w ould s i g n i f i c a n t l y re d u c e each c h i l d 's

la te n c y to com ply to p a r e n t a l commands, and s i g n i f i c a n t l y in c r e a s e each s u b j e c t 's r a t e o f s u c c e s s f u l t a s k c o m p le tio n. W hile v id e o ta p e p ro c e d u re s have been u se d in t r a i n i n g p a r e n t s in more a p p r o p r i a te c h i ld b e h a v io r m anagement p ro c e d u re s (F la n a g a n, Adams & F o re h a n d, 1979; O 'D e ll, M ahoney, H o rto n & T u r n e r, 1979)? r e l a t i v e l y few have em ployed v id e o ta p e fe e d b a c k w ith p a r e n t s o f h y p e r a c tiv e c h i ld r e n (Furm an & F e ig h n e r, 1973). No s t u d i e s to d a te h ave i n v e s t i g a t e d th e com bined e f f e c t o f sy m b o lic m odeling and p a r e n t t r a i n i n g on n o n com p lia n ce in h y p e r a c tiv e c h i ld r e n. T h e r e f o r e, a s eco n d o b je c tiv e o f th e p r e s e n t s tu d y was to e x p lo re th e com bined e f f e c t s o f s y m b o lic m o d e lin g w ith h y p e r a c tiv e c h i ld r e n and a b e h a v io r a l management program f o r th e p a r e n t s c o m p rise d o f v id e o ta p e fe e d b a c k, m o d e lin g, i n s t r u c t i o n s, and b e h a v io r a l r e h e a r s a l on th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s. I t was e x p e c te d t h a t th e f i r s t p h a se o f p a r e n t t r a i n i n g w ould r e s u l t g e n e r a lly in a s i g n i f i c a n t im provem ent in th e q u a l i t y o f p a r e n t - c h i l d i n t e r a c t i o n s, and s p e c i f i c a l l y in s i g n i f i c a n t r e d u c tio n s i n la te n c y to com ply and s i g n i f i c a n t in c r e a s e s in each c h i l d 's r a t e o f t a s k c o m p le tio n. P h ase two o f t r a i n i n g was e x p e c te d to r e s u l t in s i g n i f i c a n t r e d u c t io n s i n la te n c y to com ply and s i g n i f i c a n t im provem ents in th e r a t e o f c o m p le tin g ta s k s f o r each c h i ld com pared to p h a s e one v a l u e s.

CHAPTER II METHOD S u b je c ts S ix h y p e r a c tiv e c h i l d r e n, f iv e boys and one g i r l, ag e s if.5-1 0.5 y e a rs v /ith a mean age o f 7.3 y e a rs o ld, and t h e i r m o th ers p a r t i c i p a t e d. One f a t h e r beg an th e s tu d y, b u t w ith d re w b e c a u se o f a jo b o f f e r in a n o th e r c i t y, w h ile a n o th e r m other and h e r so n d id n o t co m p lete th e s tu d y b e c a u se tim e l i m i t s f o r th e s tu d y had e x p ire d. C h ild re n who w ere g iv e n a p rim a ry d ia g n o s is o f a t t e n t i o n d e f i c i t d is o r d e r w ith h y p e r a c t i v i t y by th e c l i n i c p s y c h i a t r i s t a t th e K alam azoo C h ild G uidance C l i n i c, and who w ere d e s c r ib e d by t h e i r m other a s n o n c o rn p lia n t w ere s e l e c t e d f o r s tu d y. S u b je c t 1 (Tommy) was a 6 y r - o ld w h ite m ale d e s c r ib e d by h i s p a r e n t s as " n o n c o rn p lia n t, p h y s i c a l l y a g g r e s s iv e, and a t t e n t i o n - s e e k i n g." He w ould f r e q u e n t ly i n t e r r u p t h i s p a r e n t s when th e y w ere u s in g th e te le p h o n e, a t m e a ltim e s, and i n p u b lic p l a c e s. He w ould a l s o f r e q u e n t ly t r i p and push h i s y o u n g er s i s t e r, and n o t fo llo w th ro u g h w ith p a r e n t a l r e q u e s t s, e. g., p u t t i n g on h i s p a ja m a s, p ic k in g up h i s t o y s. Tommy was on,20mg o f R i t a l i n and 25mg o f M e l l a r i l f o r th e d u r a t io n o f th e s tu d y. The m e d ic a tio n s w ere a d m in is te r e d a p p ro x im a te ly th r e e h o u rs b e f o r e each s e s s i o n. 7

S u b je c t 2 ( P h i l i p ) was an 8 i y r - o ld w h ite m ale r e p o r t e d by h i s m other a s " n o n c o rn p lia n t, v e r b a l l y a b u s iv e, and p h y s i c a l l y a g g r e s s iv e." He w ould v e r b a l l y r e f u s e to com ply w ith m a te rn a l commands, and f r e q u e n t ly y e l le d a t and h i t h i s m other and 13 y r - o ld s i s t e r. H is p a r e n t s had b een d iv o rc e d f o r f i v e y e a r s, and P h i l i p was c u r r e n t l y v i s i t i n g h i s f a t h e r t h r e e days each w eek. P h i l i p b eg an th e s tu d y on 20mg o f P i t a l i n SR w hich was a d m in is te r e d a p p r o x im a te ly fo u r h o u rs b e f o r e each s e s s i o n. At th e end o f th e b a s e l i n e p h a s e h i s m e d ic a tio n was w ith d ra w n upon th e r e q u e s t o f h i s m o th e r. T h e r e f o r e, d a ta re c o r d e d i n th e p o s t - b a s e l i n e p h a s e s r e f l e c t p a r e n t - c h i l d i n t e r a c t i o n s in d e p e n d e n t o f th e in f l u e n c e o f p s y c h o s tim u la n t m e d ic a tio n. S u b je c t 3 ( E r i c ) was a L-? y r - o ld w h ite m ale d e s c r ib e d by h i s m other a s " n o n c o rn p lia n t, p h y s i c a l l y a g g r e s s iv e and o v e r a c tiv e." E r ic was an a d o p te d f o s t e r c h i l d. H is b i o l o g i c a l m o th er e x p e rie n c e d m u l tip l e p s y c h i a t r i c i n s t i t u t i o n a l i z a t i o n s. E r ic e x h i b ite d g ran d m al s e iz u r e s when o n ly a c o u p le o f m onths o ld, and had e x p e rie n c e d a number o f g ra n d m al and p e t i t mal s e iz u r e s s in c e t h a t tim e r. He was ta lc in g th r e e m e d ic a tio n s f o r th e d u r a t io n o f th e s tu d y w hich in c lu d e d : 50mg o f M e l l a r i l, th r e e tim e s d a i l y, ; LOmg o f D i l a n t i n, fo u r tim e s d a i l y, and 3 mg o f D epakene, th r e e tim e s a d a y. E ric r e c e iv e d a l l th r e e m e d ic a tio n s a p p ro x im a te ly one h o u r b e f o r e ea ch s e s s i o n.

9 S u b je c t if (Shavrn) was a 10- y r - o ld w h ite m ale r e p o r t e d by h i s m other a s " n o n c o rn p lia n t, w h in y, and v e r b a l l y a b u s iv e." He w ould become v e r y q u a rre ls o m e w ith h i s m other and w ould r e s o r t to "b ab y t a l k " when i n t e r a c t i n g w ith h e r. S h aw n 's p a r e n t s had b een d iv o r c e d f o r f o u r y e a rs and h i s m other r e m a r r ie d. Shawn was ta k in g 25mg o f M e l l a r i l and 20mg o f R i t a l i n f o r th e d u r a t io n o f th e s tu d y. The M e l l a r i l was a d m in is te r e d a p p r o x im a te ly e i g h t h o u rs b e f o r e each s e s s i o n, w h ile th e R i t a l i n was g iv e n 30 m in u te s p r i o r to b e g in n in g e a ch s e s s i o n. S u b je c t 5 (J a c o b ) was a 7 y r - o ld w h ite m ale r e p o r t e d by h i s g ran d m o th er a s " n o n c o rn p lia n t, e m o tio n a lly d i s t a n t, and d e s t r u c t i v e." J a c o b 's f a t h e r was c u r r e n t l y s e r v in g a p r is o n te r m, and h i s m o th er d ie d from i n j u r i e s s u s t a in e d i n an a u to m o b ile a c c i d e n t. A cco rd in g t o h i s g ran d m o th er J aco b w ould n o t t o l e r a t e a f f e c t i o n a t e p h y s ic a l c o n t a c t from o t h e r s, e. g., h o ld in g and r o c k in g. lie was a l s o d e s c r ib e d to be im p u ls iv e, i. e., a c t i n g w ith o u t t h i n k in g. Ja c o b was on 20mg o f R i t a l i n SR th ro u g h o u t th e s tu d y w hich was a d m in is te r e d a b o u t f o u r h o u rs b e f o r e each s e s s i o n. F i n a l l y, s u b j e c t 6 (M aggie) was a 7z y r - o ld w h ite fem a le d e s c r ib e d by h e r p a r e n t s a s " n o n c o rn p lia n t, and v e r b a l l y and p h y s i c a l l y a b u s iv e w ith s i b l i n g s and p e e r s. " M other r e p o r t e d a h i s t o r y o f r e c u r r e n t e a r i n f e c t i o n s and p r e s e n c e o f a m ild sp e e c h d i s o r d e r, i. e., th e im p o s itio n o f an " s " sound a t th e b e g in n in g o f w o rd s. M aggie was

10 c u r r e n t l y g iv e n 25 mg o f M e l l a r i l and 20mg o f R i t a l i n SP a p p ro x im a te ly one h o u r b e f o r e d a t a c o l l e c t i o n. B oth m e d ic a tio n s w ere i n e f f e c t f o r th e d u r a t io n o f th e s tu d y. P ro c e d u re The p r e s e n t s tu d y em ployed an ABC e x p e rim e n ta l d e s ig n w ith tw o d i f f e r e n t i n t e r v e n t i o n p h a s e s. F o llo w in g in fo rm ed c o n s e n t and p r i o r to th e c o l l e c t i o n o f b a s e l in e d a ta each p a r e n t u n d erw en t an i n i t i a l b e h a v io r a l a s s e s sm e n t in t e r v ie w. The p u rp o s e o f th e i n t e r v ie w was t o g a th e r in f o r m a tio n r e l e v a n t to th e c h i l d 's d e v e lo p m e n ta l h i s t o r y, i d e n t i f i c a t i o n, s p e c i f i c a t i o n, and p r i o r i t i z a t i o n o f p ro b le m b e h a v io r s, and c o m p le tio n o f a r e in f o rc e m e n t s u rv e y i n o rd e r to i d e n t i f y p o t e n t i a l s o u r c e s o f re w a rd s f o r each c h i l d. A ls o, a t t h i s tim e ea ch p a r e n t was g iv e n a P a r e n t Q u e s tio n n a ir e to co m p le te (C o n n o rs, 1973) so a s to o b ta in p r e tr e a tm e n t l e v e l s o f h y p e r a c t i v i t y and p a r e n t a l r a t i n g s o f th e c u r r e n t l e v e l o f th e c h i l d 's b e h a v io r a l f u n c t io n in g. B a s e lin e The b a s e l in e p h a s e (A) was i n e f f e c t f o r fo u r c o n s e c u tiv e w eeks. B e h a v io r a l o b s e r v a tio n s we r e m ade, b u t t h e r e w ere no e x p e rim e n ta l m a n ip u la tio n s. Each b a s e l in e s e s s i o n c o n s is te d o f a 1 0 -m in u te f r e e - p l a y p e r io d fo llo w e d by a f iv e - m in u te s t r u c t u r e d - t a s k s i t u a t i o n. P r i o r to th e f r e e - p l a y p e r io d each p a r e n t was i n s t r u c t e d to : " I n t e r a c t

w ith y o u r c h i l d, u s in g any o f th e m a te r i a ls a v a i l a b l e, as you m ig h t a t home i f you had some s p a r e tim e and,w ere n o t e x p e c tin g to be i n t e r r u p t e d." The r e s e a r c h e r th e n l e f t th e p a r e n t and c h i l d a lo n e to p la y. A v a r i e t y o f to y s and gam es, e. g., v/ooden b lo c k s, b o o k s, an S tc h - a - S k e tc h b o a rd, c ra y o n s, c o lo r in g b o o k, c o n s tr u c tio n p a p e r, s c i s s o r s, p a s t e, ta p e, and c la y v/ere p r o v id e d i n th e o b s e r v a t io n room f o r th e d y ad. O b s e rv a tio n s o f th e 1 0 -m in u te p la y p e r io d v/ere co n d u c te d v i a a t e l e v i s i o n c o n s o le i n an a d j a c e n t room. The c o n s o le was c o n n e c te d d i r e c t l y to th e v id e o ta p e cam era v/hich was u n o b tr u s iv e ly p o s itio n e d i n a f a r c o rn e r o f th e o b s e r v a tio n room b e h in d a s m a ll b o o k c a se. F o llo w in g th e 10 m in u te s o f p la y a 25 v /a tt g re e n l i g h t b u lb, w hich was lo c a te d i n a c o rn e r o f th e room n e a r c e i l i n g l e v e l, was b r i e f l y f la s h e d on th e n tu r n e d o f f. T h is s tim u lu s s ig n a l e d th e o n s e t o f th e s t r u c t u r e d - t a s k c o n d i tio n to th e p a r e n t, and p ro m p ted th e p a r e n t to g iv e th e c h i l d th e f i r s t command. The g re e n l i g h t was f la s h e d on and o f f a t one m in u te i n t e r v a l s f o r th e d u r a t io n o f th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n. Each tim e th e g re e n l i g h t f la s h e d th e p a r e n t was r e q u i r e d to g iv e t h e i r c h i ld a new command. Commands w ere ty p e d on 3x5 in d e x c a rd s and p r e s e n te d to each p a r e n t p r i o r to each s e s s i o n. The commands p rom pted. th e c h i l d to c a r r y o u t a v a r i e t y o f t a s k s, e. g., ta lc in g o f f and p u t t i n g on h i s s h o e s, c le a n in g up th e f l o o r, p u t t i n g

12 away a l l th e t o y s, w a lk in g a lo n g a b la c k l i n e on th e f l o o r, s i t t i n g i n a c h a i r, e t c. A ll s t r u c t u r e d - t a s k s i t u a t i o n s w ere v id e o ta p e d, w h ile f r e e - p l a y p e r io d s w ere n o t r e c o r d e d. The p u rp o s e o f th e 1 0 -m in u te f r e e - p l a y p e r io d was to a c c lim a te th e p a r e n t and c h i l d to th e en v iro n m e n t o f th e o b s e r v a tio n room, and t h e r e f o r e was n o t v id e o ta p e d. The p u rp o s e o f th e s t r u c t u r e d - t a s k c o n d i tio n was to a s s e s s th e q u a l i t y o f th e p a r e n t - c h i l d i n t e r a c t i o n s and to d e te rm in e th e d e g re e o f n o n co m p lia n ce to p a r e n t a l commands p r i o r to t r e a tm e n t. Sym bolic M odeling F o llo w in g th e i n i t i a l b a s e l in e p h a s e, th e f i r s t tr e a tm e n t i n t e r v e n t i o n, sy m b o lic m o d e lin g, c o m p ris in g th e seco n d p h a se (B) o f th e s tu d y, w ent i n t o e f f e c t. T h is i n t e r v e n t i o n p h a se was s i m i l a r to th e b a s e l in e p h a se i n t h a t each p a r e n t and c h i l d w ere r e q u i r e d to engage i n a 1 0 -m in u te f r e e - p l a y p e r io d and a f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n. H ow ever, f o llo w in g th e 1 0 -m in u te f r e e - p l a y p e r io d th e i n v e s t i g a t o r e n te r e d th e o b s e r v a tio n room and i n v i t e d th e c h i l d to accom pany him to an a d j a c e n t room to view " s o m e th in g on T.V.." Each c h i ld was p o s itio n e d d i r e c t l y i n f r o n t o f th e t e l e v i s i o n s c r e e n and i n s t r u c t e d t o w atch th e T.V.. They w ere in fo rm e d t h a t a f t e r v ie w in g th e T.V. se q u e n c e th e y w ould be a s k e d s e v e r a l q u e s tio n s a b o u t w hat th e y saw on T.V., and t h a t f o r each q u e s tio n answ ered

c o r r e c t l y th e y w ould r e c e iv e a n i c k e l. The p u rp o s e o f t h i s c o n tin g e n c y was to e n s u re t h a t each c h i l d was a t te n d i n g to th e T.V. a s i n a t t e n t i v e n e s s i s a symptom w hich f r e q u e n t ly acco m p an ies h y p e r a c t i v i t y. A ls o, t h i s fo rm a t a llo w e d th e i n v e s t i g a t o r to q u ic k ly check as to w h e th e r th e c h i l d was a b le t o e x t r a c t th e m essage o r r u l e, i. e., " I s h o u ld do w hat mom a s k s me to d o." Each c h i l d was shown a one m in u te v id e o ta p e d se q u e n c e d e p i c tin g a same s e x, a g e - e q u iv a l e n t m odel e x h i b i t i n g a p p r o p r i a te c o m p lia n t b e h a v io r in re s p o n s e to a d u l t commands. Each c h i l d m odel on th e v id e o ta p e d s e q u en ce e m itte d f i r s t - p e r s o n, s e l f - g u i d i n g s ta te m e n ts w h ile c a r r y i n g o u t th e r e q u e s te d b e h a v io r. R e s e a rc h s u p p o rt e x i s t s d e m o n s tra tin g t h a t f i r s t - p e r s o n comments by v id e o ta p e m odels a r e more e f f e c t i v e th a n n a r r a t i v e, th i r d - p e r s o n comments i n p ro d u c in g b e h a v io r change in o b s e r v e r s (J a k ib c h u k & S m e r ig lio, 1 9 76). Ilo d e l c o n seq u e n c e s hav e b een e x t e n s iv e l y r e s e a r c h e d (T h e le n & R e n n ie, 1 9 7 2 ). A lthough m odeled b e h a v io r can be a c q u ir e d by o b s e r v a tio n a lo n e, re w a rd s a r e c r i t i c a l i f o b s e rv e d b e h a v io r i s t o be p e rfo rm e d and m a in ta in e d o v er tim e. V ic a rio u s r e in f o rc e m e n t i s i n d i c a t e d when o b s e rv e r s i n c r e a s e b e h a v io r f o r w hich th e y h ave s e e n o th e r s re w a rd e d. As B an d u ra (1977) p o in t s o u t, re w a rd e d m o d e lin g i s more e f f e c t i v e th a n m o d e lin g a lo n e. I f th e outcom e e x p e rie n c e d by th e m odel i s v a lu e d by th e o b s e r v e r th e n th e g r e a t e r

Imp r o b a b i l i t y th e o b s e rv e r w i l l e n a c t th e m odeled b e h a v io r on some f u tu r e o c c a s io n u n d e r s i m i l a r s tim u lu s c o n d i tio n s. T h u s, each one m in u te v id e o ta p e d seq u e n c e u sed i n th e sy m b o lic m o d e lin g p h a s e, and th r o u g h o u t th e l a s t p h a se o f th e s tu d y, d e p i c te d a m odel r e c e iv in g v a lu e d re w a rd s c o n tin g e n t upon com p ly in g to p a r e n t a l commands. Fach v id e o ta p e m odel r e c e iv e d a n ic k e l fo llo w in g c o m p lia n ce as a l l o b s e rv in g c h i l d r e n w ere r e p o r t e d by t h e i r p a r e n t s to v alu e money. F o llo w in g o b s e r v a tio n o f th e m odeled seq u e n c e each, h y p e r a c tiv e c h i l d was a sk e d f iv e q u e s tio n s : 1) "7/hat d id th e m o th er a s k th e c h i l d to do?" 2) M77hat d id th e c h i ld do?" 3 ) "7/hat d id th e c h i l d s a y w h ile d o in g w hat m other a s k ed?" if) "Y/hat d id th e m o th er s a y to th e c h i l d a f t e r he d id w hat sh e a sk e d? " and 5) "Y/hat d id th e c h i ld g e t f o r d o in g w hat m o th er ask e d? " I f th e c h i l d s u c c e s s f u l l y met th e c r i t e r i o n o f a n s w e rin g fo u r o u t o f f i v e q u e s tio n s c o r r e c t l y, th e n he o r sh e was r e u n i t e d w ith th e m other in th e o b s e r v a tio n room. I f th e c h i l d d id n o t m eet th e e s t a b l i s h e d c r i t e r i o n, t h e n '- ' he o r s h e was r e q u i r e d to view th e v id e o ta p e seq u e n c e a seco n d tim e. A g a in, th e c h i l d was a sk ed th e same f iv e q u e s tio n s. T h is p ro c e d u re c o n tin u e d u n t i l th e c h i ld s u c c e s s f u l l y met th e e s t a b l i s h e d c r i t e r i o n. F o llo w in g r e u n io n o f th e c h i ld v /ith th e m other i n th e o b s e r v a t io n room th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d itio n was i n e f f e c t. A g ain, a s i n b a s e l i n e, each m other p r e s e n te d

f i v e d i f f e r e n t commands a t a p p ro x im a te ly o n e -m in u te i n t e r v a l s a s s ig n a l e d by th e g re e n l i g h t. A ll s t r u c t u r e d - t a s k i n t e r a c t i o n s b etw e en p a r e n t and c h i l d w ere v id e o ta p e d. P a r e n t T ra in in g F o llo w in g fo u r tr e a tm e n t s e s s i o n s w ith sy m b o lic m o d e lin g a lo n e a seco n d tr e a tm e n t c o n d i tio n, p a r e n t t r a i n i n g (C ), was a p p lie d c o n c u r r e n tly w ith sy m b o lic m o d e lin g o v e r th e f i n a l p h a s e o f th e s tu d y. P r i o r to i n i t i a t i n g p a r e n t t r a i n i n g each p a r e n t was r e q u e s te d to c o m p le te a q u e s tio n n a ir e ( O 'D e l l, T a r le r - B e n lo lo & F ly n n, 1979) i n o r d e r to m easu re know ledge o f b e h a v io r a l p r i n c i p l e s a s a p p lie d to c h i l d r e n. The p a r e n t t r a i n i n g p h a s e c o n s is te d o f two s e q u e n c e s. The f i r s t se q u e n c e was c o m p rised o f two s e s s i o n s and beg an w ith th e r e s e a r c h e r re v ie w in g th e q u e s tio n n a ir e w ith each p a r e n t and p r o v id in g a r a t i o n a l e f o r th e c o r r e c t a n s w e rs. N e x t, t h r e e t a r g e t b e h a v io r s o r p a r e n t in g s k i l l s w ere ta u g h t t o each p a r e n t and in c lu d e d : a t t e n d i n g, ig n o r i n g, and re w a rd in g. " A tte n d s " a r e e s s e n t i a l l y a ru n n in g com m entary on th e c h i l d 's a c t i v i t y o r a p p r o p r i a te i n - s e s s i o n b e h a v io r, and as s u c h, p r o v id e a more c o n s ta n t s o u rc e o f a t t e n t i o n th a n re w a rd s. A tte n d in g r e q u i r e d each p a r e n t to v e r b a l l y d e s c r i b e th e c h i l d 's o n g o in g - b e h a v io r, e. g., " Y o u 're s ta c k in g th e b lo c k s," o r "H ere comes th e t r u c k." When

a t te n d i n g each p a r e n t was i n s t r u c t e d n o t to a s k q u e s ti o n s, g iv e commands, t r y t o d i r e c t, t r y to s t r u c t u r e o r i n t e r r u p t, o r t r y to tu r n i t i n t o a te a c h in g s e s s i o n, b u t r a t h e r to u se a t te n d i n g o n ly to d e s c r i b e a p p r o p r i a te c h i l d b e h a v io r. Ig n o r in g was u s e d to d e c r e a s e th e c h i l d 's in a p p r o p r ia te b e h a v io r by f o llo w in g th e s e g u id e lin e s : 1) no eye c o n ta c t o r v e r b a l cu es a s each p a r e n t was i n s t r u c t e d to tu r n a t l e a s t 9 0 * away from th e c h i l d, 2) no v e r b a l c o n t a c t as each p a r e n t was t o l d n o t to t a l k o r a t te n d to th e c h i ld when he o r s h e d id so m e th in g in a p p r o p r i a t e, and 3 ) wo p h y s ic a l c o n t a c t f o llo w in g i n a p p r o p r i a t e c h i l d b e h a v io r. R ew arding was im p lem ented by each p a r e n t i n th e form o f v e r b a l p r a i s e c o n tin g e n t upon th e c h i l d 's i n i t i a t i o n o f co m p lia n ce in re s p o n s e to p a r e n t a l commands. P a r e n ts w ere i n s t r u c t e d to f o llo w th e s e g u id e lin e s when re w a rd in g t h e i r c h i l d f o r a p p r o p r i a te c o m p lia n t b e h a v io r: 1) rew ard th e c h i l d im m e d ia te ly upon th e i n i t i a t i o n o f c o m p lia n c e, 2) re w a rd th e c h i l d im m e d ia te ly fo llo w in g te r m in a tio n o f th e ta s k r e q u e s t e d, 3 ) re w a rd s s h o u ld be c o n s i s t e n t l y a p p lie d a f t e r e v e ry t a s k c o m p le te d, and re w a rd s sh o u ld be ta s k s p e c i f i c. A tte n d in g and ig n o r in g w ere e m itte d by each p a r e n t i n b o th th e f r e e - p l a y and s t r u c t u r e d - t a s k c o n d i tio n s th ro u g h o u t th e e n t i r e p a r e n t t r a i n i n g p h a s e. R ew arding was a p p lie d o n ly d u rin g th e s t r u c t u r e d - t a s k s i t u a t i o n f o r a p p r o p r i a te c o m p lia n t b e h a v io r.

The f i r s t s e q u e n c e o f p a r e n t t r a i n i n g c o n s is te d o f d i d a c t i c i n s t r u c t i o n s, t h e r a p i s t m o d elin g o f a p p r o p r i a te a t t e n d i n g, i g n o r i n g, and re w a rd in g b e h a v io r, fo llo w e d by b e h a v io r a l r e h e a r s a l by each p a r e n t w ith c o r r e c t i v e fe e d b a c k p ro v id e d by th e r e s e a r c h e r. The m ajor p u rp o s e o f th e f i r s t two w eek s e q u e n c e o f p a r e n t t r a i n i n g was to change th e p a t t e r n o f p a r e n t - c h i l d i n t e r a c t i o n s from a n e g a tiv e to a more p o s i t i v e e x c h a n g e. P a r e n ts w ere i n s t r u c t e d to p r a c t i c e a l l t h r e e new s k i l l s ta u g h t in th e f i r s t se q u e n c e f o r a t l e a s t 15 m in u te s d a i l y w ith t h e i r c h i l d. The p u rp o s e o f t h i s b etw e en s e s s i o n homework a s s ig n m e n t was to f a c i l i t a t e p o s i t i v e b e h a v io r change i n each p a r e n t - c h i l d r e l a t i o n s h i p. The s e c o n d s e q u e n c e o f th e p a r e n t t r a i n i n g p h ase c o n s is te d o f fo u r s e s s i o n s d u rin g w hich th r e e new p a r e n t s k i l l s w ere ta u g h t: 1) how to g iv e commands, 2) n o t r e p e a t i n g commands, and 3 ) u s in g a tim e - o u t p r o c e d u r e. The m ajo r p u rp o s e o f t h i s se c o n d sequen ce was to d e c re a s e th e r a t e o f n o n co m p lia n ce to p a r e n t a l commands. T h roughout t h i s se c o n d s e q u e n c e each p a r e n t c o n tin u e d to p r a c t i c e th e t h r e e s k i l l s ta u g h t i n t h e f i r s t s e q u e n c e o f t r a i n i n g, i. e., a t t e n d i n g, ig n o r i n g, and r e w a rd in g. In g iv in g commands each p a r e n t was ta u g h t to f i r s t g e t th e c h i l d 's a t t e n t i o n by c a l l i n g th e c h i l d 's f i r s t name and p a u s in g u n t i l eye c o n t a c t was e s t a b l i s h e d. Then i n a f irm and s l i g h t l y lo u d e r th a n u s u a l to n e o f v o ic e g iv e

18 one s p e c i f i c command. N e x t, a f t e r th e command was p r e s e n te d each p a r e n t was i n s t r u c t e d t o c o u n t s i l e n t l y to t e n. 3ach p a r e n t was t o l d n o t t o i s s u e a d d i t i o n a l w o rd s, s ta t e m e n ts, o r any v e r b a l i z a t i o n u n t i l th e c h i l d b eg an to com ply. I f a f t e r c o u n tin g s i l e n t l y to te n th e c h i l d had n o t i n i t i a t e d c o m p lia n ce th e n th e p a r e n t was to is s u e a w a rn in g : " I f... t h e n..., 1' e. g., " I f you do n o t p ic k up th e t o y s, th e n you w i l l hav e to s i t i n th e c h a ir i n th e c o r n e r.! Each p a r e n t th e n c o u n te d s i l e n t l y to te n f o llo w in g th e w a rn in g. I f th e c h i l d i n i t i a t e d co m p lia n c e f o llo w in g th e w arn in g s ta te m e n t th e n th e p a r e n t p r a i s e d th e c h i l d. I f th e c h i ld s t i l l f a i l e d to b e g in co m p ly in g to th e p a r e n t a l command a f t e r th e w a rn in g th e n a tim e - o u t (TO) p ro c e d u re was im p lem en ted. I n c a r r y i n g o u t th e TO p ro c e d u re each p a r e n t was i n s t r u c t e d to ta k e th e c h i l d f ir m ly by th e hand and p la c e him o r h e r i n th e c h a ir lo c a te d i n th e c o rn e r o f th e room. The p a r e n t th e n re s p o n d e d by s a y in g, " S in c e you d id n o t do a s I a s k e d, you h ave to s i t i n th e c h a ir u n t i l I s a y you ca n g e t u p. Each p a r e n t was a d v is e d n o t to p ro v id e a r a t i o n a l e o r a rg u e w ith th e c h i l d w h ile ta k in g th e c h i ld t o TO, o r w h ile th e c h i l d was i n TO. The c h i ld was r e q u i r e d t o re m a in i n TO f o r t h r e e m in u te s. R e le a s e from TO was c o n tin g e n t upon s i t t i n g q u i e t l y i n th e c h a ir f o r 15 seco n d s a f t e r th e t h r e e m in u te s had e x p ir e d. The p a r e n t w ould th e n r e t u r n to th e c h a i r, rem ove th e c h i l d, and r e p e a t th e o r i g i n a l command. Once th e o r i g i n a l command was r e p e a te d

th e n th e e n t i r e se q u e n c e o f e v e n ts beg an a g a in w ith th e p a r e n t s i l e n t l y c o u n tin g to te n f o r c o m p lia n ce to be i n i t i a t e d. T h u s, th e c h i l d c o u ld n o t a v o id com p ly in g to a p a r e n t a l command i f th e TO p ro c e d u re was c o n s i s t e n t l y and c o r r e c t l y c a r r i e d o u t c o n tin g e n t upon n o n c o m p lia n c e. A b a c k -u p p ro c e d u re f o r a c h i l d le a v in g th e TO c h a ir p r e m a tu re ly was a l s o i n e f f e c t. The f i r s t tim e t h i s h appened th e p a r e n t was to s a y, " I f you g e t o f f th e c h a ir a g a in, I w i l l s p an k y o u." T h is w a rn in g was o n ly g iv e n o n c e. I f th e c h i ld th e n l e f t th e c h a i r a g a in b e f o r e p a r e n t a l r e l e a s e from TO he o r sh e was r e t u r n e d to th e TO c h a i r and g iv e n two s p an k s on th e b o tto m w ith an open h a n d. The c h i ld was th e n p la c e d b ack i n th e TO c h a ir and th e p a r e n t r e p e a te d th e w arning. P a r e n t t r a i n i n g was c o n d u c te d i n a room a d ja c e n t to th e o b s e r v a tio n room a t th e c l i n i c, and was i n e f f e c t f o r th e l a s t e ig h t w eeks o f th e s tu d y. P a r e n t t r a i n i n g was c a r r i e d o u t p r i o r to ea c h s e s s i o n s 1 0 -m in u te f r e e - p l a y p e r i o d. D u rin g p a r e n t t r a i n i n g each c h i l d was i n s t r u c t e d to p la y a lo n e i n th e o b s e r v a t io n room. A f te r th e p a r e n t t r a i n i n g s e s s i o n th e p a r e n t was r e u n i t e d w ith h e r c h i ld and a llo w e d 10 m in u te s o f f r e e - p l a y. F o llo w in g th e f r e e - p l a y p e r io d th e c h i ld view ed a n o th e r v id e o ta p e d s e q u e n c e w ith th e i n v e s t i g a t o r, and th e n was r e t u r n e d to h i s o r h e r m o th er f o r th e f iv e - m in u te s t r u c t u r e d - t a s k c o n d i tio n w hich was v id e o ta p e d. F o llo w in g th e end o f th e s eco n d sequen ce o f

p a r e n t t r a i n i n g,e a c h p a r e n t co m p leted a n o th e r P a re n t Q u e s tio n n a ir e to p r o v id e a p o s ttr e a tm e n t m easure o f h y p e r a c t i v i t y and o v e r a l l b e h a v io r a l f u n c t io n in g o f each c h i l d. 20 D ependent V a r ia b le s An o b s e r v a tio n c o d in g sy ste m was d e v e lo p e d w hich a llo w e d f o r th e c o n tin u o u s r e c o r d in g o f 17 d i f f e r e n t p a r e n t and c h i ld b e h a v io r s o p e r a t i o n a l l y d e fin e d a s f o llo w s : 1. A tte n d (A ): V e rb a l com m entary o f o n g o in g c h i l d b e h a v io r. 2. C om pliance (Coin): P h y s i c a l c o n ta c t w ith th e o b je c t o f th e command w ith in fiv e seconds of end of command. 3. E x t in c t io n ( E x t): No i n t e l l i g i b l e re s p o n s e f o r th e e n t i r e 10 seco n d i n t e r v a l. A. L a te n c y (L ): Time from end o f command to p h y s ic a l c o n t a c t w ith th e o b je c t o f p a r e n t a l command. 3. n e g a tiv e N o n v erb al ( I TV) : T a n tru m s, s p a n k in g, p in c h, h i t, k ic k, th ro w t h i n g s, s h o v e, p ush o r yank on th i n g s. 6. N e g a tiv e V e rb a l (-V ): D ir e c t d is a p p r o v a l o r c r i t i c i s m, w h in in g, c r y i n g, s w e a rin g, n o, d o n 't, s t o p, q u i t, t h a t ' s n o t r i g h t, t h a t ' s a l l w rong, t h a t i s n o t c o n tin g e n t upon c h i ld n o n com p lia n ce to p a r e n t a l command. 7. Ilo n com p lian ce (NCom): No p h y s ic a l c o n ta c t w ith th e o b je c t o f th e command w ith in f iv e s e c o n d s o f end o f th e command. 8. O th e r (O th e r ) : Any o th e r form o f b e h a v io r t h a t does n o t